New Jersey Mental Health and Nutritional Group LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

NEW JERSEY MENTAL HEALTH AND NUTRITIONAL GROUP LLC

Practice address

3 Marigold Dr Apt B
Maple Shade, NJ 08052-8470

Phone

(732) 344-0604

NPI assigned

Sep 7, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Evangaline Croix

Title

Owner/LCSW

Phone

(732) 344-0604

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536278400000",
    "number": "1912480765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MARIGOLD DR APT B",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080528470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MARIGOLD DR APT B",
            "city": "MAPLE SHADE",
            "state": "NJ",
            "postal_code": "080528470",
            "telephone_number": "732-344-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY MENTAL HEALTH AND NUTRITIONAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-07",
        "last_updated": "2018-09-07",
        "status": "A",
        "authorized_official_last_name": "CROIX",
        "authorized_official_first_name": "EVANGALINE",
        "authorized_official_title_or_position": "OWNER/LCSW",
        "authorized_official_telephone_number": "732-344-0604"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Maple Shade, NJ
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.